1. Articles from Divyesh V. Sejpal

    1-5 of 5
    1. Optical coherence tomography of the pancreatic and bile ducts: are we ready for prime time?

      Optical coherence tomography of the pancreatic and bile ducts: are we ready for prime time?

      Background and study aims  First-generation optical coherence tomography (OCT) has been shown to increase diagnostic sensitivity for malignant biliary and pancreatic-duct strictures. A newer OCT imaging system, NVision Volumetric Laser Endomicroscopy (VLE), allows for in vivo cross-sectional imaging of the ductal wall at the microstructure level during endoscopic retrograde cholangiopancreatography (ERCP). The aim of this study was to identify and evaluate characteristics on OCT that are predictive of benign and malignant strictures. Patients and methods  Consecutive patients from six centers who underwent OCT between September 2016 and September 2017 were included in a dedicated registry. OCT images were analyzed, and ...

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    2. Incremental yield of dysplasia detection in Barrett’s esophagus using volumetric laser endomicroscopy with and without laser marking compared with a standardized random biopsy protocol

      Incremental yield of dysplasia detection in Barrett’s esophagus using volumetric laser endomicroscopy with and without laser marking compared with a standardized random biopsy protocol

      Background and Aims Volumetric laser endomicroscopy (VLE) is a new wide-field advanced imaging technology for Barrett’s esophagus (BE). No data exist on incremental yield of dysplasia detection. Our aim is to report the incremental yield of dysplasia detection in BE using VLE. Methods This is a retrospective study from a prospectively maintained database from 2011 to 2017 comparing the dysplasia yield of 4 different surveillance strategies in an academic BE tertiary care referral center. The groups were (1) random biopsies (RB), (2) Seattle protocol random biopsies (SP), (3) VLE without laser marking (VLE), and (4) VLE with laser marking ...

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    3. Volumetric laser endomicroscopy in Barrett’s esophagus: interobserver agreement for interpretation of Barrett’s esophagus and associated neoplasia among high-frequency users

      Volumetric laser endomicroscopy in Barrett’s esophagus: interobserver agreement for interpretation of Barrett’s esophagus and associated neoplasia among high-frequency users

      Abstract Background and Aims Targeting neoplasia in Barrett’s esophagus (BE) is challenging. Volumetric laser endomicroscopy (VLE) is a new imaging technique that allows for real time cross-sectional microstructure imaging that can detect BE neoplasia. The interobserver agreement among users in practice is unknown. Methods Eight high-volume users of VLE from different academic centers in the United States evaluated 120-stored VLE images blinded to the endoscopic and clinical findings. There were 30 images for each tissue type: gastric cardia, esophageal squamous mucosa, non-neoplastic BE, and neoplastic BE. Each image with BE had corresponding histology confirming the tissue diagnosis. Each normal ...

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    4. Volumetric laser endomicroscopy can target neoplasia not detected by conventional endoscopic measures in long segment Barrett’s esophagus

      Volumetric laser endomicroscopy can target neoplasia not detected by conventional endoscopic measures in long segment Barrett’s esophagus

      Methods and study aims: The incidence of esophageal cancer is rising despite increased surveillance efforts. Volumetric laser endomicroscopy (VLE) is a new endoscopic imaging tool that can allow for targeted biopsy of neoplasia in Barrett’s esophagus. We report a series of 6 patients with long-segment Barrett’s esophagus ( > 3 cm), who underwent a session of endoscopy with volumetric laser endomicroscopy, after a separate prior session of standard high-definition endoscopy with narrow band imaging (NBI) and random biopsies that did not reveal neoplasia. In all six patients, the first endoscopy was the index endoscopy diagnosing the Barrett’s esophagus. All ...

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    5. Finding a needle in a haystack: use of volumetric laser endomicroscopy in targeting focal dysplasia in long-segment Barrett’s esophagus

      Finding a needle in a haystack: use of volumetric laser endomicroscopy in targeting focal dysplasia in long-segment Barrett’s esophagus

      A 64-year-old man underwent esophagoscopy 15 months earlier, which diagnosed long-segment Barrett’s esophagus. Examination of random biopsy specimens yielded a diagnosis of intestinal metaplasia, with 1 biopsy specimen as indefinite for dysplasia. Two subsequent esophagoscopies were performed 6 months apart, and random biopsy specimens were negative for dysplasia. The patient was referred for volumetric laser endomicroscopy (VLE) (NVisionVLE, NinePoint Medical, Cambridge, Mass). At esophagoscopy, high-definition white-light endoscopy showed a 7-cm segment of flat salmon-colored mucosa (Prague class C6M7) ( A ).

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    1-5 of 5
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    1. (4 articles) NinePoint Medical
    2. (1 articles) Massachusetts General Hospital
    3. (1 articles) Harvard University
    4. (1 articles) Guillermo J. Tearney
    5. (1 articles) Michael B. Wallace
    6. (1 articles) University of Sydney
    7. (1 articles) University of Zurich
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    Finding a needle in a haystack: use of volumetric laser endomicroscopy in targeting focal dysplasia in long-segment Barrett’s esophagus Volumetric laser endomicroscopy can target neoplasia not detected by conventional endoscopic measures in long segment Barrett’s esophagus Volumetric laser endomicroscopy in Barrett’s esophagus: interobserver agreement for interpretation of Barrett’s esophagus and associated neoplasia among high-frequency users Incremental yield of dysplasia detection in Barrett’s esophagus using volumetric laser endomicroscopy with and without laser marking compared with a standardized random biopsy protocol Optical coherence tomography of the pancreatic and bile ducts: are we ready for prime time? Optical coherence tomography features of neovascularization in proliferative diabetic retinopathy: a systematic review Retinal microvascular metrics in untreated essential hypertensives using optical coherence tomography angiography Optical coherence tomography angiography findings of fellow eye of proliferative macular telangiectasia type 2: Long term study Reorganization of the perifoveal microvasculature after macular hole closure assessed via optical coherence tomography angiography Optical coherence tomography angiography (OCTA) findings in Serpiginous Choroiditis Changes in retinal layer thickness with maturation in the dog: an in vivo spectral domain - optical coherence tomography imaging study Optical coherence tomography angiography analysis of fabry disease